Unresolved issues and controversies surrounding the management of colorectal cancer liver metastasis

Table 3 Review of large studies (all retrospective except [57,58]) focusing on a comparison of neoadjuvant chemotherapy followed by hepatic resection versus hepatic resection alone for resectable colorectal cancer liver metastases

Author	Year	N ^a	TT, n	Morbidity, %	Mortality, %	PFS, mo	OS, m	Conclusions
Mehta [54]	2008	173	130 NC+HR 43 HR alone	nr	nr	nr	nr	NC was associated with regimen-specific hepatic injury. However, this did not increase postoperative morbidity and Mortality
Mehta [54]	2008	173	130 NC+HR 43 HR alone	nr	nr	nr	nr
Scoggins [55]	2009	186	112 NC+HR	49	0	40	56	Similar remarks as Mehta et. Al
			74 HR alone	47	7	56	65
Pawlik [53]	2007	212	153 NC+HR 59 HR alone	35	0	nr	nr	Preoperative chemotherapy is associated with hepatic injury in 20 to 30% of patients and the type of injury was regimen-specific
Pawlik [53]	2007	212	153 NC+HR 59 HR alone	30	4	nr	nr
Nordlinger [57,58]	2008	364	151 NC+HR 152 HR alone	25	0.66	19	61	In resectable CRLM, ^bChemotherapy does not improve OS. However, it improves PFS
Nordlinger [57,58]	2008	364	151 NC+HR 152 HR alone	16	1.3	12	54
Vauthey [52]	2006	406	248 NC+HR 158 HR alone	23	14.7	nr	nr	NC induces regimen-specific significant liver injury and increases mortality after liver resection
Vauthey [52]	2006	406	248 NC+HR 158 HR alone	18	1.6	nr	nr
Welsh [56]	2007	497	252 NC+HR	29	2	nr	nr	Liver resection for CRLM is safe following NC
			245 HR	27	2	nr	nr
Reddy [61]	2009	499	297 NC+HR	nr	nr	nr	53	NC was not associated with improved RFS and OS
			202 HR alone	nr	nr	nr	36
^cAdam [50]	2010	1471	169 NC+HR	37	2.1	nr	nr	NC did not improve the outcome of patients with resectable CRLM
			1302 HR alone	24	1.9	nr	nr

^aOnly those studies with N ≥150 and relatively comparable number of patients in both treatment options were considered in this table.
^bChemotherapy was administered as perioperative (before and after hepatic resection); ^cPFS and OS are reported not in months but in % and there is no significant difference in both groups.
HR, hepatic resection; N, total number of patients; n, number of patients in either of the treatment options; NC, neoadjuvant chemotherapy for liver metastases; nr, not reported; TT, type of treatment.

ISSN: 1477-7819